中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (18): 3285-3289.doi: 10.3969/j.issn.1673-8225.2012.18.013

• 细胞与组织移植 cell and tissue transplantation • 上一篇    下一篇

经肝动脉及经门静脉异种胰岛移植治疗1型糖尿病恒河猴★

叶  斌，廖  坚，聂  唯，梁  琪，董  琼，马小倩，王  维，刘  晟   

  1. 中南大学湘雅三医院放射科，湖南省长沙市 410013
  • 收稿日期:2011-12-14 修回日期:2011-12-23 出版日期:2012-04-29 发布日期:2012-04-29
  • 通讯作者: 刘晟，博士，教授，主任医师，硕士生导师，中南大学湘雅三医院放射科，湖南省长沙市 410013
  • 作者简介:叶斌★，男，1970年生，湖南省长沙市人，汉族，1995年中南大学湘雅医学院毕业，硕士，副主任医师，主要从事分子影像学及胰岛移植方面的研究。yebin9992003@163.com

Heterogeneous islet transplantation via hepatic artery versus portal vein for typeⅠdiabetes in rhesus monkeys   

Ye Bin, Liao Jian, Nie Wei, Liang Qi, Dong Qiong, Ma Xiao-qian, Wang Wei, Liu Sheng   

  1. Department of Radiology, Third Xiangya Hospital of Central South University, Changsha  410013, Hunan Province, China
  • Received:2011-12-14 Revised:2011-12-23 Online:2012-04-29 Published:2012-04-29
  • Contact: Liu Sheng, Doctor, Professor, Chief physician, Master’s supervisor, Department of Radiology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
  • About author:Ye Bin★, Master, Associate chief physician, Department of Radiology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China yebin9992003@163.com

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摘要：

背景：经门静脉及经肝动脉是胰岛移植治疗1型糖尿病的2种途径，经门静脉途径并发症较多，经肝动脉移植创伤小，并发症少，但缺乏深入研究。
目的：对经肝动脉及经门静脉异种胰岛移植治疗糖尿病恒河猴模型的疗效进行比较。
方法：将18只恒河猴糖尿病模型分成经肝动脉组(n=6)、经门静脉组(n=9)及对照组(n=3)。经肝动脉组采用Seidinger技术肝动脉插管经导管植入处理好的新生猪胰岛(50 000胰岛当量/kg)；经门静脉组在超声引导下门静脉穿刺经导管植入处理好的新生猪胰岛(50 000胰岛当量/kg)；对照组2只经门静脉穿刺注入门静脉组等量生理盐水，1只经肝动脉注入肝动脉组等量生理盐水。各组均使用相同免疫抑制方案。
结果与结论：肝动脉组及门静脉组外源性胰岛素的用量较移植前分别平均减少约59.53%，48.39%，2组间外源性胰岛素减少的百分比差异无显著性意义(P > 0.05)；肝动脉组及门静脉组血清猴C-肽一直保持在较低的水平，而血清猪C-肽的水平逐渐升高，2组之间血清猪C-肽浓度差异无显著性意义(P > 0.05)，但门静脉组因移植后不同并发症出现4/9只糖尿病猴死亡，而肝动脉组仅因穿刺点渗血死亡1只，提示经肝动脉肝内移植途径操作较经门静脉途径更安全、简便，并发症及不良反应小，移植物均能长期成活并发挥生理功能。
 

关键词: 胰岛移植, 门静脉, 肝动脉, C-肽, 肝肾功能, 恒河猴

Abstract:

BACKGROUND: Islet transplantation via portal vein and hepatic artery to treat diabetes are the main two ways. The portal vein way has more complications; the hepatic artery transplantation has less trauma and complications.
OBJECTIVE: To compare the efficiency of heterogeneous islet transplantation via hepatic artery and portal vein in the treatment of diabetes rhesus monkeys.
METHODS: Eighteen diabetes rhesus monkey models were divided into three groups: hepatic artery group (n=6), portal vein group (n=9) and control group (n=3). In hepatic artery group, the handled new pig islets (50 000 islet equivalents/kg) were implanted in the models through the hepatic artery catheterization by Seidinger technique; in portal vein group, the handled new pig islets (50 000 islet equivalents/kg) were implanted in the models through the portal venipuncture by ultrasonic guidance; in the control group, two models were preformed with saline injection through the portal venipuncture and one model was performed with saline injection in the same dose with the hepatic artery group via hepatic artery. All groups received the same immunosuppressive regimen. 
RESULTS AND CONCLUSION: The dosage of exogenous insulin administrated in hepatic artery group and portal vein group were decreased to 59.53% and 48.39% respectively. There were no significant differences between hepatic artery group and portal vein group in decreasing dosage of exogenous insulin administration (P > 0.05). Both groups had low level of rhesus serum C peptide, whereas the level of pig serum C petide was increased gradually. There was no significant difference in pig serum C peptide lever between two groups (P > 0.05). However, 4/9 diabetes rhesus monkeys in the portal vein group were dead due to different complications after transplantation, only 1 diabetes rhesus monkey was dead in hepatic artery group due to the puncture point bleeding. The procedure of transplantation via hepatic artery is safer, easier and with fewer complications compared with transplantation via portal vein. The xeno islet grafts can survive for a long time and maintain functional in both approaches.

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